MEDICARE: RACHEL ALLYN MYERS M.A., CCC-SLP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist	6191	NC

General Provider Information

NPI Number	:	1487860458
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RACHEL ALLYN MYERS M.A., CCC-SLP

Provider Business Mailing Address
First Line	:	7301 CARMEL EXECUTIVE PARK DR
Second Line	:	302
City	:	CHARLOTTE
State	:	NC
Zip	:	28226-8251
Country	:	US
Telephone Number	:	704-540-3777
Fax Number	:	704-540-1443

Provider Business Practice Location Address
First Line	:	7301 CARMEL EXECUTIVE PARK DR
Second Line	:	302
City	:	CHARLOTTE
State	:	NC
Zip	:	28226-8251
Country	:	US
Telephone Number	:	704-540-3777
Fax Number	:	704-540-1443

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/15/2007
Last Update Date	:	07/08/2007

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